2016 Community Health Needs Assessment

Transcription

1 2016 Community Health Needs Assessment General Overview The Community Health Needs Assessment (CHNA) for 2016 is the second CHNA completed for LifeCare Medical Center s service area. This service area includes all of Roseau County which has a population of approximately 15,630 residents. Roseau County includes the rural cities of Warroad, Roseau, Badger and Greenbush. Approximately 94% of the population or 15,630 residents of Roseau County are white. Very small minority populations reside in Roseau County. There are a total 751 minority residents which include: Asian (2.3%), American Indian (1.2%) and African American (.2%) and Latino (.7%). LifeCare provides medical / surgical services, special care services, twenty-four hour emergency room services, a full range of laboratory and imaging services, rehabilitation services (physical therapy, occupational therapy, and cardiopulmonary rehabilitation), behavioral health services, hospice, home care and palliative care. In addition to hospital services, LifeCare hosts sixty beds of long-term care at the Roseau campus, forty beds of long-term care and twelve assisted living apartments in Greenbush. Quantitative Data Overview Demographic Trends (2010 U.S. Census Data) Roseau County is experiencing a declining population Education rates are substantially lower than the rest of the state Roseau County has a lower median income than the rest of Minnesota. Population trends show higher than average percentages of adults 65+. Health-Related Trends (2012 data as reported in 2016 County Health Rankings) Attachment A Roseau County is medically underserved o 1 primary care physician for every 1,720 residents state average 1,100:1 o 1 dentist for every 2,610 residents state average 1,500:1 o 1 mental health provider for every 5,230 residents state average 490:1 Adult obesity rate has risen to 33% of Roseau County (BMI>30) which is the 2 nd worse rate in the state Adult smoking rates are above the state average Youth smokeless tobacco rates are two times the state average Chronic Conditions in Roseau County (2012 All Payer Claims Database as compiled by MDH) Attachment B We are between 25 15% below the statewide average of 354/1,000 in Prevalence of Chronic Conditions when adjusted for differences in age, sex, length of enrollment and payer mix. However o We are between 5-15% above the statewide rate of 208/1,000 in Prevalence of High Blood Pressure. o We are between 15 25% above the statewide rate of 23/1,000 in Prevalence of Congestive Heart Failure. o We are more than 25% above the statewide rate of 21/1,000 in Prevalence of Ischemic Heart Disease.

2 We are more than 25% (34-43/1,000) below the statewide rate of 58/1,000 for Prevalence of Depression. Roseau County s adjusted average annual health care spending for residents with any chronic condition was between 5 and 15% higher than the statewide average. Generally, Roseau County s annual cost of treating individual chronic diseases is equal to or less than the statewide average cost of treating chronic diseases SHIP Survey Results Executive Summary (Quin CHB includes 5 counties of NW MN) Attachment C 66% of respondents who consumed alcohol beverages during the 30 days preceding the survey, 30% of them binge drank (5 or more drinks per sitting male, 4 or more female) Only 18% are getting their recommended levels of physical activity and 82% are not. o 26% of respondents indicated no physical activity and statewide average is 13% Roseau County had a reported smoking rate of 21% and statewide average of 14% 39% of adults eat five or more servings of fruit and vegetables(recommended daily allowance). The total rises to 70% if you include those that indicated that they get 3-4 servings per day. Our food environment index is 8.3 on a scale of 1-10 which equals the top U.S. performing counties. Qualitative Data Overview While more statistical information is available compiled and reported by national (2016 County Health Rankings), state(mdh All Claims Payer Database - Chronic Conditions in Minnesota, January 2016) and regional (Quin CHB SHIP Survey Northwest Region Adult Health Behavior Survey, April 2016) sources, there is a gap between the date the data being utilized (most was collected from 2012 surveys and claims) was collected and the date of the findings or report. The exception to this is the QUIN SHIP survey which was performed in late 2014 and reported in Although these reports are very useful in determining past behaviors and trends in health needs, they do not identify health needs outside of problems that may not be measured whether it is because they aren t identified as a prior health problem, need or because they have yet to be identified. Therefore, in an effort to identify new and emerging trends since our last CHNA in 2013 or data collected between , LifeCare Marketing and LifeCare Public Health collected community input on health needs for Roseau County through a series of meetings with targeted individuals and groups who represented all age and geographic levels for our service area between January 2016 and March Specifically, input was solicited from Roseau County Social Services, Roseau County Public Health, Northwest Community Action and Headstart who serve low-income and minority populations in our service area. The following grid shows the entire list of participants, the age and community they represent for this assessment:

3 Community Advisory Committee Participants Organization Age Demographic Community Roseau Ministerial Association (6 Representatives) 65+ Roseau Area Warroad School Nurse 0-18 Warroad Area Warroad Chamber of Commerce (5 Representatives) 25- Elderly Warroad Area Altru Physician Provider Meeting (5 Representatives) Birth - Elderly All Communities Roseau County Court (Law Clerk) 15 -Elderly All Communities Headstart/Early Headstart (3 Representatives) LifeCare Home Care Public Health and Hospice (2 Representatives) Greenbush School 3 Educators Badger School Dean of Students & Social Worker Birth Preschool 18-35(Parents) Birth - Elderly Preschool - 18 Preschool-18 Roseau, Warroad, Badger All Communities Greenbush Area Badger Area Marvin Windows and Doors (2 HR Representatives) Warroad Area Roseau School District (Social Worker, Nurse & Ass t Principal) Preschool - 18 Roseau Central Boiler, Inc HR Rep Polaris Industries, Inc (HR Rep and On-site Nurse) Greenbush Area Roseau Area Roseau County Social Services (15 Representatives) Birth Elderly All Communities

4 The responses from these individual meetings were then compiled into a comprehensive list of community health needs for the LifeCare Medical Center Service Area. The health needs that were mentioned by five or more community groups that were interviewed included: 1. Drug Abuse - New drugs showing up Marijuana, Meth. Prescription Drugs are not mentioned -Meth use is being reported by health care providers during pregnancy and by dental providers 2. Individual Financial Problems -Financial problems are affecting work and employee family? -Individuals are not prioritizing discretionary spending -People have unplanned healthcare costs and chronic disease healthcare costs they are not able to pay for -People have skewed view of middle class status (they are at poverty level but think they are middle class) 3. Healthy Parenting - People don't have tools or resources to parent -Parents don t actively seek answers to parenting questions -Lack of resources for parents of teens 4. Affordable Housing - lack of quality housing - lack of safe and affordable housing 5. Lack of Transportation - To healthy food access - Healthcare -Social services 6. Mental Health Access Issues -Missing appointments because of absence from schools and worksites -Long wait to get in for appointments - Distance to appointments - Immediate crisis intervention resource needed and can t access (this may have been resolved since it was reported) -Lack of cooperation between county, school, healthcare and social services -Social Services lost mental health resources to retirement and relocation 7. Obesity 8. Tobacco Use -Observed use among young, working adults and high school teens is higher than previously thought 9. Alcohol abuse -Prevalence of alcohol abuse is higher than reported in Behavioral Risk Surveillance Survey among young adults

5 Other responses: Mentioned by at least 3 groups Higher than state average incidence for STD's NW Minnesota culture has not been open to healthy eating and exercise changes. Too busy! Mentioned by at least 2 groups Grandparents raising grand kids Unconnected people, no sense of community, hard to fit in Young, unmarried women (18-24) having a child (children) because of lack of birth control utilization or using it as a problem solving mechanism Chronic disease rate in NW Minnesota is significantly higher than statewide average Mentioned by at least 1 group Poor management of chronic disease Difficulty educating and communicating treatment plans to the Lao population Limited internet in rural parts of county reduces social connectedness and access to health information Tick transmitted diseases on the rise 1-2 unplanned high school teen pregnancy. May be the result of lack of planned parenthood in region New cases of TB Drug & Alcohol needs insurance referral and appointment for referral and in HR we are unsure on how to do that Access to same day provider appointments at Altru Clinic-Greenbush, especially work comp related visits Access Mental Health Crisis Response Team Domestic Violence concerns for victims and perpetrators Concussions in kids in high school Issues in order of occurrences in cases coming through Roseau County Courts: o DWI o Domestic Abuse o Bad Checks o year old hard drug use o No Drivers licenses or working cars o Quality, affordable housing o Mental Illness o Obesity-take this out as it was mentioned earlier and not court issue Cancer HS and Young adult drug and alcohol abuse Lack of social outings for young couples and families Unwillingness to reach out to those marginalized by society LGBTQ, Alcoholics, Mental Health Sufferers Chewing Tobacco at an all-time high Nutritional choices are skewed such as cutting weight for wrestling, snickers and Mountain Dew for breakfast High incidence of ALS - Roseau, MS - all over Lack of people training and willing to be first responders Because no school nurse miss out on wellness and health education opportunities Wellness or fitness center access is severely limited

6 Bullying continues through personal contact and social media Increase in suicide due to mental health issues and drug abuse Increase in number of kids qualifying for special Ed services Lack of Urgent Care providers Social Service Outreach in Warroad i.e. Transportation and available hours impeding residents from accessing services and benefits Need pediatric and teen mental health providers Food insecurity because no transportation or limited food shelf hours Increase in type 2 diabetes in students especially Native American populations Lack of cooperation and communication between crossover agencies who are working with the same youth and families Increase in number of incarcerated parents Unsafe housekeeping practices among the elderly and they are unwilling to access services Gambling issues in Warroad may be a problem? Underage children operating ATV's and Snowmobiles without helmets or safety training Inattentive parents because of Smartphones Increase in misinformation of health issues due to social media Limited Dental Access for MA patients Latchkey kids (unattended at home, businesses and arena) Lack of affordable daycare Lack of dementia services Shortage of people to fill jobs in long-term care, group homes, assisted living, etc. Increase in suicide with young males most at risk Prioritizing the Results Taking the top health needs identified by five or more of the groups interviewed, prioritizing was completed by utilizing three groups of community members representing different county communities and demographics. These groups included Team EPIC that has members representing 14 sectors of the community such as education, law enforcement, health care, social services, city and county officials. The other two groups polled included, area Headstart educators and School professionals from across the county and the LifeCare Board and Altru Medical Staff. They were given a form with the topics mentioned by 5 or more groups (including the bullet points) and asked to circle(but not rank) the three most important health needs in the community. The complete results including number of respondents for each group polled and their top responses are in Attachment D. Top Community Health Needs of Roseau County 1. Mental Health Access 21% of Respondents 2. Drug Abuse 20% of Respondents 3. Individual Financial Problems 13% of Respondents 4. Healthy Parenting 13% of Respondents 5. Alcohol Abuse 14% of Respondents 6. Obesity 9% of Respondents 7. Tobacco Use 5% of Respondents 8. Affordable Housing 3% of Respondents 9. Lack of Transportation 1% of Respondents

7 Community Health Needs Implementation Plan LifeCare Medical Center will adopt an organization specific implementation strategy in response to the Community Health Needs Assessment report. This implementation strategy will be discussed and approved by the Board of Directors of LifeCare Medical Center and will be repeated in three years as required by federal regulations. Community members who would like to provide input on the next CHNA process, or would like to provide feedback on the results of the assessment are encouraged to contact Deb Haugen, Director of Community Relations at (218) with their inquiries, suggestions or comments.

8 Attachment D Team Epic HeadStart/School Professionals LifeCare Board and Med Staff Total Drug Abuse 12 24% 18 19% 11 14% 41 20% Individual Financial Problems 4 8% 15 16% 8 14% 27 13% Healthy Parenting 12 24% 12 13% 3 5% 27 13% Affordable Housing 2 4% 5 5% % Lack of Transportation % % Mental Health Access 12 24% 20 21% 11 19% 43 21% Obesity 2 4% 4 4% 12 21% 18 9% Tobacco Use 1 2% 3 3% 6 11% 10 5% Alcohol Abuse 5 10% 16 17% 6 11% 27 13% Total